Anesthesia: wounds without pain…but are they wounds without consequences? Keep reading to find out how osteopathic manual therapy can help you recover post-anesthesia. You may think that since you’ve been discharged from the hospital or have given birth that your body will work to recover without the need of assistance. While that may be true for some, for others, they would benefit from additional help and osteopathic manual therapy can provide that!
Types of anesthesia
The most familiar to you may be general anesthesia; where they put you to sleep so that you are unconscious for the procedure. While, a local anesthesia is where you remain awake, but they inject a local anesthetic into the area they are working. Examples include before dental work or before they stitch you up.
One that you may be surprised to know is associated with anesthesia is an epidural. This is where they inject anesthetic into the epidural space around the spinal cord which enables it to cross the dura to have a numbing effect on the spinal nerves. Most commonly used during childbirth.
Another one to quickly mention is the spinal tap. This is not an injection of anesthetic but a diagnostic procedure where they collect cerebrospinal fluid to help rule out the cause of headaches, seizures, bacteria in the body, multiple sclerosis and even brain bleeds. We note it only as it may leave a scar in the body that requires treatment. And you know what osteopathic practitioners think about scars See previous blogs about this topic!
Side effects of anesthesia
When you wake up from surgery which included general anesthetic, you may experience many or none of these side effects: nausea, vomiting, sore throat, cognitive dysfunction, muscle aches, itching, chills, back pain, difficulty urinating or other gastrointestinal dysfunction.
With local anesthetic, minimal side effects are usually noted. You may be sore or itchy in the spot where they injected the medication.
With an epidural, there may be scarring where the needle entered the dural space. And by now you know, scars require treatment!
Your body and general anesthesia
Surgery, including general anesthesia, can impact your entire body. Let’s start with your neuroendocrine system. Your body is not only under stress from the procedure but also the medications; this may cause your body to secrete hormone which affect your lymphatic and immune systems, which can make you vulnerable to post-operative infections.
Surgery to the chest, abdomen or pelvis can have an impact on your respiratory rate. It can affect your vital capacity, your tidal volumes, your functional residual capacity and your alveolar ventilation rate. This in turn wreaks havoc on your diaphragm which can increase muscle and fascial tensions throughout the body, in addition to leading to a slowdown of your overall lymphatic flow. This slowdown in lymph can change the pH in the body and create an inflammatory environment for your tissues. This increase in inflammation in the body may present as an increase in pain, a decrease in circulation and/or a decrease in venous return. Dysfunction can occur in areas of the body where there is bogginess due to lack of circulation and venous return, as this type of environment does not provide a good exchange between oxygen and nutrients.
The composition of the anesthesia itself can even create issues. Anesthesia contains peptides and neurotransmitters which impact gut motility. It varies between individuals, but can cause either an increase or decrease in gut motility. The anesthesia can affect the afferent and efferent reflexes back to the spine, or in other words, it has an impact on the neural reflexes in the gut. We’ve blogged before about the vagus nerve – here’s another prime example of the gut/brain connection. Changes in the respiratory rate, impacts our autonomic nervous system balance which in turn impacts gastrointestinal motility…see how we are all connected.
Osteopathic treatment and how it can help with recovery from anesthesia
It can take your body over a week to clear anesthesia from your body as long as you were healthy going into surgery with minimal somatic dysfunction. And who amongst us doesn’t have tight muscles?!
Our osteopathic goals following surgery are to improve lymphatic drainage, balance your autonomic nervous system to ensure good tone between your sympathetic and parasympathetics, to ensure healthy gut motility and clear out any somatic dysfunctions…which in turn will enable you to return to your activities of daily living as quickly as possible. So how do we do that?
Your osteopathic practitioner will assess all your systems, including but not limited to; your musculoskeletal, circulatory, digestive, endocrine, respiratory, gynecological and nervous systems.
Depending on how your body presents in the clinic determines where the treatment starts. A good start usually includes the musculoskeletal system to remove any large somatic dysfunctions. Somatic dysfunction describes a great many things, including fascial tension, tight muscles or joints that are in dysfunction in your skeletal system. By cleaning up this system, it helps to regulate your sympathetic nervous system to ensure appropriate neural reflexes which leads to normal pain responses, and contributes to good circulation including arterial, venous and lymph return.
We know that decreased lymph drainage can increase venous pressure leading to swelling and tissue congestion. By working to increase your lymph drainage, it helps to reduce your healing timelines, flush the anesthesia from the body, and reduce your risk of infection. We will look to improve your lymph drainage by working numerous areas, but one to mention is the thoracic inlet. The thoracic inlet is close to your upper ribs and myofascial work here on the connective tissue helps to ensure the upper ribs are free to move which helps with your respiratory system in addition to ensuring good sympathetic tone on top of decreasing congestion in the tissues. That being said, this is not the only place to work on lymph drainage, but certainly one place not to ignore! We know that the sympathetic nervous system also plays a role in the lymph system as it controls the diameter of the vessels. By addressing and ensuring good balance between your sympathetic and parasympathetic nervous systems it helps with the drainage, and also ensuring good tone and reciprocity between the two systems.
Treating the diaphragms in the body, including those in the thorax and pelvis helps to normalize the pressures in the body, and in turns aids in circulation and lymph drainage. Treatment here can decrease muscle tone, decrease pain levels and help you to breathe without pain.
You may also benefit from visceral work to ensure your organs and viscera are biomechanically working in conjunction with the diaphragm and are not causing or being impacted by neural reflexes from the nervous system.
Now the above is not a comprehensive list of what your body may require post procedure but is designed to give you a snapshot of how you may require additional assistance once you’ve been discharged from the hospital. If you research the topic, some practitioners describe being unconscious during surgery as losing the connection between your prefontal and frontal lobes of the brain and your sight, hearing, pain and movements. Now if you believe this, wouldn’t you like some assistance once you wake up to ensure that this connection is re-established?
If you want to chat further or have questions, feel free to reach out!